Weight Loss

I was dx with mod to severe r/a in 1983 and am 57 yrs old.  I have always been a small person and never a big eater.  But have now started to experience weight loss with my r/a. My usual wt is 115-120 but now have lost between 5 to 10 lbs up and down.  I'm just not that big a person to begin with and have also experiened loss in muscle mass.

I also have Secondary Sjorgens and prob Burning Mouth.  My symptoms are: dry mouth, dry eyes and my taste buds are shot.  I have trouble eating breads, rice, pasta, etc because they tend to stick in my mouth like a glob of glue (plus my teeth aren't the best).  I wear dentures and have broken a tooth while eating an ice cream bar. (going to heck in a handbasket).  Foods don't have the taste they used to..nothing tastes like it once did. My lips are sensitive to salad dressing, tomato sauce, condiments, anything with a vinegar taste or acidic. I can develop a canker sore just by drinking a glass or orange juice.  I am limited to what I can eat.  I have been drinking Ensure Plus and try to maintain my weight that way...it seems to give me my energy but not much in weight (I drink 3 per day).

I take 5 mg prednisone a day until my rheumy changes my meds to whay he thinks is best for me.  I don't see him until June.  But do want to gain weight before that time.

With my Sjorgens..rheumy has told me to eat sugar free candy and drinks lots of water..but the more water I drink the less hungry I am.  I see my rheumy every 4 months.  I also have a primary dr I see.  Blood tests are always taken.  

My ? is:  
1) what can I do to gain more weight?
2) can I drink more Ensure Plus or is there a better nutritional product to drink?
3) are there any OTC products I can buy to stimulate my appetite?
4) is there a liquid product that will help me gain weight?
5) an appetite stimulator OTC

Please add anything that you feel is necessary.

Thank you..Paula  R/A sufferer for 23 yrs.

[Kevin Pho, MD]

To answer your questions:
1) To put on more weight - you have to determine what the cause is first.  If it is due to a rheumatological disorder - it should be corrected.  I would ensure that things like thyroid dysfunction has been ruled out.  If all the diseases have been evaluated for, you can consider a referral to a dietician to conduct calorie counts.

2) Ensure Plus is generally acceptable.  I am not aware of studies that compare supplements against each other.

3) I am not aware of studies suggesting that OTC products have efficancy in gaining weight.

4) Again, I am not aware of such a product.

5) Before resorting to medications, you have to rule out other diseases first.  If an appetite stimulator is necessary, you can consider the prescription medication Megace.  I am not aware of an OTC option.

You can discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b